Electrical activity of the heart Flashcards

1
Q

What is the combination of electrical and physical connections in cardiac muscle called?

A

Functional syncytium

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2
Q

What is cardiac muscle electrically connected by?

A

Gap junctions which are protein channels

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3
Q

What physically connects cardiac muscle?

A

Desmosomes

These form intercalated discs

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4
Q

What are T-tubules?

A

Deep invaginations of sarcolemma

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5
Q

What is the sarcoplasmic reticulum?

A

Essentially the calcium store

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6
Q

What do the intercalated discs do?

A

Allow the cardiac muscles to act like one cell even though each cell has its own nucleus

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7
Q

What is the sequence of events for contraction?

A
  • Action potential enters via contractile cell and moves across sarcolemma and into t-tubules
  • Calcium flows out of SR and into cytosol
  • Diffuses across cytosol to the contractile elements
  • Binds to troponin and initiates cross-bridge formation and sliding filament movement
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8
Q

What happens in relaxation?

A
  • When cytoplasmic calcium concentrations decrease, calcium unbinds from troponin
  • Myosin releases actin
  • Contractile filaments slide back to their relaxed position
  • Calcium is transported back to ST via Ca2+-ATPase
  • Calcium is removed from the cell in exchange for Na+
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9
Q

How does the cardiac cell have a graded contraction?

A
  • Force generated is proportional to number of active cross-bridges
  • Number of cross-bridges active is determined by how much Ca2+ is bound to troponin
  • If more calcium enters from the extracellular fluid, more Ca2+ is released from SR
  • Myosin forms more cross-bridges with actin
  • Additional contractile force
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10
Q

What is the resting membrane potential of a non-pacemaker cell? Why?

A
  • 80mV

Due to high resting P_K+

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11
Q

Why does the initial depolarisation in a non-pacemaker cell occur?

A

Increase in P_Na+

Cardiac cells have high voltage gated sodium channels and open when there’s a huge depolarisation

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12
Q

Why does the action potential plateau in a non-pacemaker cell?

A

Increase in P_Ca2+ and increase in P_K+
The slower voltage gated calcium channels open
Potassium permeability also drops to allow for further depolarisation

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13
Q

What causes repolarisation in non-pacemaker cells?

A

Calcium channels shut and permeability increase for K+

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14
Q

Why is there a long refractory period in non-pacemaker cells?

A

Slower voltage gated sodium channels opening
Last for as long as muscle twich
Prevents tetanus as there’s no summation

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15
Q

What is initial membrane potential of a pacemaker cell?

A

It is -60 mV and gradually rises to a threshold of -40 mV

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16
Q

Why is the pacemaker potential so complex?

A

Gradual decrease in Pk+, leakiness decreases
Early increase in PNa+, increase in permeability opened by repolarisation from previous action potential
Late increase in PCa2+, tiny calcium channels that let calcium in

17
Q

What are some examples of modulators of electrical activity?

A
  • Sympathetic and parasympathetic systems
  • Drugs
  • Temperature
  • Hyper/hypokalaemia
  • Hyper/hypocalcemia
18
Q

Specifically which drugs modulate electrical activity? What do they do?

A

Ca2+-channel blockers: decrease force of contraction

Cardiac glycosides: increase force of contraction, calcium

19
Q

How does temperature alter electrical activity?

A

Increases by ~10 beats/min/°C
Ions pass through channels quicker
This is why there’s tachycardia in fever

20
Q

How does hyperkalaemia modulate electrical activity?

A

High plasma K+

Fibrillation & heart block

21
Q

What is fibrillation?

A

Depolarises cells
Action potentials fire spontaneously
Leads to uncoordinated firing

22
Q

What is heart block?

A

Depolarised speed of propagation slows down

Can slow down so much that it stops

23
Q

How does hypokalaemia modulate electrical activity?

A

Fibrillation and heart block
Starts to polarise and then depolarise
Same net effect as hyperkalaemia

24
Q

How does hypercalcemia modulate electrical activity?

A

High plasma Ca2+

Increased HR and force of contraction

25
How does hypocalcemia modulate electrical activity?
Decreased HR and force of contraction
26
What is the order of the spread of electrical activity?
SAN -> annulus fibrosus -> atrioventricular node -> bundle of His -> Purkinje fibres
27
What is the sinoatrial node?
Pacemaker Gives off a slow moving wave of depolarisation Heart will beat to the fastest pacemaker which is the SAN 0.5 m/s
28
What is the annulus fibrosus?
Non-conducting, no signal | Junction between the atria and ventricles
29
What is the atrioventricular node?
Delay boxy Signal canot go through annulus fibrosus so it has to go through the AVN Slows down AP to allow blood out 0.05m/s
30
What is the bundle of His?
Spilts into the left and right bundle branch
31
What are the Purkinje fibres?
Come from bundle branches Rapid conduction system 5m/s
32
What does the P wave correspond to?
Atrial depolarisation
33
What does the QRS complex correspond to?
Ventricular depolarisation
34
What does the T wave correspond to?
Ventricular repolarisation